Neurovascular Conflicts of Cerebellopontine Angle: A Review of the Literature
The pathology of the cistern of the Cerebellopontine angle is primarily the
disease of the nervous and vascular structures that it contains and of the meninges that line it.
Knowledge of its anatomy and pathogenesis makes it possible to understand and search for
a rare pathology, including Trigeminal Neuralgia, Hemifacial spasm , and Glossopharyngeal Neuralgia.
Trigeminal neuralgia consists of brief paroxysms of pain in the facial
distribution of the trigeminal nerve, precipitated by stimuli to sensory endings in the
trigeminal receptive area.
The overall incidence is estimated to be approximately 3-5 cases per
year per 100,000 people and increases with age.
HFS is a facial movement disorder characterized by involuntary,
unilateral and intermittent twitching of muscles innervated by the facial nerve.
Like in TN, in more than 95% of the cases HFS is caused by neurovascular
compression affecting the Root Exit Zone of the facial nerve. Medical imagery, based on the
Magnetic Resonance Imaging (MRI), is systematic and enables us to preview the conflict.
We have reviewed the anatomy, pathogenesis, diagnostics and therapy of neurovascular conflicts of
cerebellopontine angle.
The vertebra-basilar arterial system is never perfectly
symmetrical: the unilateral Vertebral Artery (VA) is all the more
bulky as its counterpart contralateral hypoplastic. The basilar artery can be also very tortuous.
Thus, these large arterial trunks or their branches can come in contact with the various nervous
structures of the CPA and produce there a mechanical aggression
on both peripheral and central nervous tissues10 leading to various signs and symptoms of neuralgias.
The “ephaptic” theory refers to the development of a true short-circuit electric activity
that may occur by time between fibers constituting the nerve.
Neuro Open J. 2015; 2(3): 99-105. doi: 10.17140/NOJ-2-119
